Using the concept of Food Based Dietary Guidelines to Develop an Optimized Mixed Diet (OMD) for German children and adolescents.

OBJECTIVE: To apply for the first time FAO/WHO standards for Food Based Dietary Guidelines (FBDG) to develop a total diet concept named Optimized Mixed Diet (OMD) for children and adolescents in a European country.

METHODS: Exact 7-day menus were composed for sample age groups of children (4-6 years) and adolescents (13-14 years), taking into account the German meal patterns, common non-fortified foods, and sensory preferences of children (practical criteria). Food amounts and food selection within the menus were optimized so far as to achieve a total of reference intakes for 22 nutrients (scientific criteria). Simple food based messages were deduced.

RESULTS: Compared to the existing high-fat, low plant food diet reported from the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study), the OMD is lower in fat and saturated fatty acids and contains ample amounts of plant foods. Reference nutrient densities for age groups between 1 and 18 years were achieved or exceeded, except folate. Foods from the optimized menus were summarized into 11 food groups based on nutritional and practical considerations. Proportions of food groups by weight are independent of age and can be used to recalculate food amounts for various age groups or energy requirements, respectively. For simplification, "recommended" foods were distinguished from "tolerated" foods by their nutrient densities; based on food amounts, 3 simple rules for food consumption were deduced, i.e. beverages and plant foods: ample; animal foods: moderate; high-fat, high-sugar foods: sparingly.

CONCLUSIONS: Exact menus and food amounts are a prerequisite to ascertain nutrient adequacy of FBDG. The OMD demonstrates that a single diet concept with a core of quantified food groups can be adequate for age groups between 1 and 18 years within a country, such as Germany.